Prospective comparison of five mediators of the systemic response after high-intensity focused ultrasound and targeted cryoablation for localized prostate cancer.

Abstract

OBJECTIVE:

To evaluate whether high-intensity focused ultrasound (HIFU) is less invasive than targeted cryoablation of the prostate (TCAP), as experimental studies suggest that the acute-phase reaction is proportional to surgery-induced tissue damage.

PATIENTS AND METHODS:

Between May 2004 and December 2007, 127 consecutive patients undergoing HIFU (71) or TCAP (56) in our departments were assessed prospectively. Blood samples were collected 24 h before (T0), during surgery (T1), at the end of anaesthesia (T2), and at 12 (T3), 24 (T4) and 36 h after surgery (T5). The extent of the systemic response to surgery-induced tissue trauma was measured by assessing the levels of acute-phase markers tumour necrosis factor-alpha (TNF-alpha), interleukin-6 (IL-6), IL-10, C-reactive protein (CRP) and serum amyloid A (SAA), at all sampling times in all patients.

RESULTS:

The median (interquartile range) age in the HIFU and TCAP groups was 70 (62-77) and 68 (59-75) years, respectively (P = 0.4). Baseline levels (T0) of TNF-alpha, IL-6, IL-10, CRP and SAA were comparable in both groups. The levels of all four markers increased during both procedures; the median values were higher for TCAP at T2 (P = 0.02, 0.001, <0.001 and 0.06), T3 (P < 0.001, 0.009, 0.003 and 0.001), T4 (P = 0.007, <0.001, 0.005 and <0.001) and T5 (P < 0.001, 0.004, <0.001 and 0.02), respectively. IL-6 was also higher for TCAP at T1 (P = 0.03). IL-10 did not change at the different sampling times.

CONCLUSION:

The tissue trauma and associated invasiveness of HIFU is less than that of TCAP, based on the variables objectively measured in this study.

• Authors: Liao-Yuan Li, Ming Yang, Xin Gao, Hai-Bin Zhang, Jie-Fang Li, Wen-Feng Xu, Zhe Lin, Xie-Lai Zhou
• Journal: BJU international (BJU Int) Vol. 104 Issue 8 Pg. 1063-7 (Oct 2009) ISSN: 1464-410X [Electronic] England
• PMID: 19298406 (Publication Type: Comparative Study, Controlled Clinical Trial, Journal Article, Multicenter Study)

Chemical References

• Interleukin-6
• Serum Amyloid A Protein
• Tumor Necrosis Factor-alpha
• Interleukin-10
• C-Reactive Protein

Topics

• Acute-Phase Reaction (etiology)
• Aged
• C-Reactive Protein (metabolism)
• Cryosurgery (adverse effects)
• Epidemiologic Methods
• Humans
• Interleukin-10
• Interleukin-6 (metabolism)
• Male
• Middle Aged
• Prostatic Neoplasms (therapy)
• Serum Amyloid A Protein (metabolism)
• Treatment Outcome
• Tumor Necrosis Factor-alpha (metabolism)
• Ultrasound, High-Intensity Focused, Transrectal (adverse effects)